Medication Therapy Management Program

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Medication Therapy Management: Review your Medicines

What is the Medication Therapy Management program?

Medication Therapy Management (MTM) is a Medicare designed program that helps make sure that your medications are working to maintain your health. This service is provided at no additional cost to qualified members and is not considered a Medicare Part D benefit.

If you are taking multiple medicines prescribed by more than one doctor, you could also be taking medicines that, when combined, may:

  • Reduce the effectiveness of one or more of your medicines
  • Cause severe side effects
  • Cost you more money per month

As part of your MTM Program you may set up a one-on-one review of your medicines with a pharmacist. This review is called a Comprehensive Medication Review (CMR) and is offered at no extra cost to you. However, once enrolled in the program, you may be contacted about a Targeted Medication Review (TMR) if a pharmacist identifies a potential medication issue that needs attention after the CMR is completed.

How you qualify for the program

CarePlus determines eligibility monthly, by looking at your medication claims information. Once you qualify, you remain in the program for the rest of the calendar year. You will have to re-qualify for the next calendar year. In order to qualify for the MTM Program, you must meet all three of the following criteria:

  • Have three of the five following conditions: Chronic Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), Dyslipidemia (Abnormal Cholesterol), Osteoporosis, or Diabetes; AND
  • Take eight or more chronic maintenance (Part D) prescription drugs in a 30-day period; AND
  • Likely to incur annual Part D Medication costs of at least $3,967 in 2018
  • Likely to incur annual Part D Medication costs of at least $4,044 in 2019

How you are notified of your MTM eligibility

Once eligible, you will receive a letter that invites you to call Member Services to schedule your medication review. The review will last approximately 25 minutes and will be scheduled at your convenience.

As part of your consultation, the pharmacist will:

  • Go over the medicines you are currently taking
  • Check to see if your medicines are safe for you
  • Answer questions you may have about your medicines
  • Discuss lower-cost alternatives for your medicines
  • Discuss concerns you have about your medicines
  • Work with you on ways to keep track of your medicines

You will receive a personal medication list and a summary of the medication review results (medication action plan). The medication list will help you keep track of the medications you are taking. The medication summary will offer you with steps you can take to get the best results from your medications.

For your convenience, a blank medication list may be printed by clicking the attachment below. Please use the form to keep track of all your prescriptions and over-the-counter (OTC) medications.

Printable Medication List

PDFPrintable Medication List - English(link opens in new window) 

PDFPrintable Medication List - Spanish(link opens in new window) 

Call with questions

If you have any questions, please call our Member Services number at 1-800-794-5907; TTY: 711. From October 1 - March 31, we are open 7 days a week; 8 a.m. to 8 p.m.. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may always leave a voice mail message after-hours, Saturdays, Sundays, and holidays and we will return your call within 1 business day.